| NPI | 1255312211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 50968) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: MA 50968) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MA 50968) | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2007-07-08 |